Neurological symptoms in patients with biopsy proven celiac disease
Identifieur interne : 001B35 ( Istex/Corpus ); précédent : 001B34; suivant : 001B36Neurological symptoms in patients with biopsy proven celiac disease
Auteurs : Katrin Bürk ; Marie-Louise Farecki ; Georg Lamprecht ; Guenter Roth ; Patrice Decker ; Michael Weller ; Hans-Georg Rammensee ; Wolfang OertelSource :
- Movement Disorders [ 0885-3185 ] ; 2009-12-15.
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- KwdEn :
Abstract
In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 ± 15 years, mean disease duration 8 ± 11 years) were recruited through advertisements. All participants adhered to a gluten‐free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten‐free diet. © 2009 Movement Disorder Society
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DOI: 10.1002/mds.22821
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<front><div type="abstract" xml:lang="en">In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 ± 15 years, mean disease duration 8 ± 11 years) were recruited through advertisements. All participants adhered to a gluten‐free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten‐free diet. © 2009 Movement Disorder Society</div>
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<abstract xml:lang="en"><p>In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 ± 15 years, mean disease duration 8 ± 11 years) were recruited through advertisements. All participants adhered to a gluten‐free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten‐free diet. © 2009 Movement Disorder Society</p>
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<titleGroup><title type="main" xml:lang="en">Neurological symptoms in patients with biopsy proven celiac disease<link href="#fn1"></link>
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<title type="short" xml:lang="en">Neurological Disease in CD</title>
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<creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2" corresponding="yes"><personName><givenNames>Katrin</givenNames>
<familyName>Bürk</familyName>
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<contactDetails><email>buerk@ngi.de</email>
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<creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Marie‐Louise</givenNames>
<familyName>Farecki</familyName>
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<creator xml:id="au3" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Georg</givenNames>
<familyName>Lamprecht</familyName>
<degrees>MD</degrees>
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<creator xml:id="au4" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Guenter</givenNames>
<familyName>Roth</familyName>
<degrees>PhD</degrees>
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<creator xml:id="au5" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Patrice</givenNames>
<familyName>Decker</familyName>
<degrees>PhD</degrees>
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<creator xml:id="au6" creatorRole="author" affiliationRef="#af5"><personName><givenNames>Michael</givenNames>
<familyName>Weller</familyName>
<degrees>MD</degrees>
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<creator xml:id="au7" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Hans‐Georg</givenNames>
<familyName>Rammensee</familyName>
<degrees>PhD</degrees>
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<creator xml:id="au8" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Wolfang</givenNames>
<familyName>Oertel</familyName>
<degrees>MD</degrees>
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<affiliationGroup><affiliation xml:id="af1" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, University of Marburg, Marburg, Germany</unparsedAffiliation>
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<affiliation xml:id="af2" countryCode="DE" type="organization"><unparsedAffiliation>Department of Immunology, University of Tübingen, Tübingen, Germany</unparsedAffiliation>
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<affiliation xml:id="af3" countryCode="DE" type="organization"><unparsedAffiliation>Department of Internal Medicine, University of Tübingen, Tübingen, Germany</unparsedAffiliation>
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<affiliation xml:id="af4" countryCode="DE" type="organization"><unparsedAffiliation>Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany</unparsedAffiliation>
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<affiliation xml:id="af5" countryCode="CH" type="organization"><unparsedAffiliation>Department of Neurology, University of Zürich, Zürich, Switzerland</unparsedAffiliation>
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<keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">celiac disease</keyword>
<keyword xml:id="kwd2">ataxia</keyword>
<keyword xml:id="kwd3">migraine</keyword>
<keyword xml:id="kwd4">gluten sensitivity</keyword>
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<p>In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 ± 15 years, mean disease duration 8 ± 11 years) were recruited through advertisements. All participants adhered to a gluten‐free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten‐free diet. © 2009 Movement Disorder Society</p>
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<noteGroup><note xml:id="fn1"><p>Potential conflict of interest: Nothing to report.</p>
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<titleInfo type="abbreviated" lang="en"><title>Neurological Disease in CD</title>
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<affiliation>Department of Neurology, University of Marburg, Marburg, Germany</affiliation>
<affiliation>Department of Immunology, University of Tübingen, Tübingen, Germany</affiliation>
<description>Correspondence: Department of Neurology, University of Marburg, Rudolf‐Bultmann‐str. 8, Marburg 35039, Germany</description>
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<abstract lang="en">In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 ± 15 years, mean disease duration 8 ± 11 years) were recruited through advertisements. All participants adhered to a gluten‐free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten‐free diet. © 2009 Movement Disorder Society</abstract>
<note type="content">*Potential conflict of interest: Nothing to report.</note>
<subject lang="en"><genre>Keywords</genre>
<topic>celiac disease</topic>
<topic>ataxia</topic>
<topic>migraine</topic>
<topic>gluten sensitivity</topic>
</subject>
<relatedItem type="host"><titleInfo><title>Movement Disorders</title>
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<titleInfo type="abbreviated"><title>Mov. Disord.</title>
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<identifier type="ISSN">0885-3185</identifier>
<identifier type="eISSN">1531-8257</identifier>
<identifier type="DOI">10.1002/(ISSN)1531-8257</identifier>
<identifier type="PublisherID">MDS</identifier>
<part><date>2009</date>
<detail type="volume"><caption>vol.</caption>
<number>24</number>
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<detail type="issue"><caption>no.</caption>
<number>16</number>
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